Presented by: Andrei Cumpanas MD
Department of Urology, University of California, Irvine; Orange, CA, USA

Introduction

In a recently published study from China, the diameter of the common iliac artery (dCIA) ipsilateral to the ureter was directly correlated with the successful passage of a 14Fr ureteral access sheath (UAS). This finding could guide decision-making with regard to limiting pre-operative stenting to only those patients who, based on their dCIA, would likely fail to accept a 14Fr or larger UAS. Accordingly, we sought to corroborate these findings by retrospectively measuring the dCIA on a cohort of flexible ureteroscopy (FUS) patients undergoing ureteroscopic stone treatment at our institution.

Materials

We reviewed the CT scan of 160 unstented patients in California, undergoing FUS with UAS deployment between March 2017 and September 2022.  In each patient, UAS deployment was monitored with a UCI force sensor and an appropriately sized UAS was placed.  We compared the dCIA with the successful deployment of a 12 Fr, 14 Fr or 16 Fr UAS using two statistical methodologies: a linear regression model and a logistic regression model.  

Results

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When considering both the dCIA as well as the maximum size of the UAS deployed at < 6N as continuous numerical variables, using a linear regression model, dCIA did not predict the size of the deployed UAS (R²=0.0002, p-value=0.87). In the logistic regression model, the dCIA was considered as a continuous variable, while the UAS group was defined as a binary variable: successful versus failed deployment of a 12 Fr, 14 Fr or 16 Fr UAS at < 6N[CA1] [CA2]  did not correlate with the successful deployment of the various UASs (Figure 1).

Conclusion

Among patients in California, we were unable to support the contention that the dCIA is associated with the deployment of a 12Fr, 14Fr or 16 Fr UAS at < 6N.

Funding

None.

Co-Authors

Nina H. Kar, MD
Burrell College of Osteopathic Medicine, New Mexico State University

Zachary E. Tano, MD
Department of Urology, University of California, Irvine,

Sohrab N. Ali, MD
Department of Urology, University of California, Irvine, USA

Roshan M. Patel, MD
Department of Urology, University of California, Irvine, USA

Jaime Landman, MD
Department of Urology, University of California, Irvine, USA

Ralph V. Clayman, MD
Department of Urology, University of California, Irvine, USA